(P376) Prevalence of five curable sexually transmitted infections and associated risk factors among young gay, bisexual and other men who have sex with men in urban Kenya: a respondent-driven sampling survey

Wednesday, July 26, 2023

16:00 – 18:00 CST

Primary Presenter(s)

Samuel W. Mwaniki, BPharm, MSc., PhD (he/him/his)

Pharmacist
University of Nairobi
Nairobi, Nairobi Area, Kenya

Co-author(s)

PK

Peter Kaberia

University of Nairobi, Kenya
PM

Peter Mugo

Kenya Medical Research Institute, Kenya
TP

Thesla Palanee-Phillips

Wits Reproductive Health and HIV Institute, South Africa

Background: Compared to older gay, bisexual and other men who have sex with men (herein referred to as MSM) and young heterosexual men, young MSM (including tertiary student MSM [TSMSM]) are a key population at higher risk of sexually transmitted infections (STIs), yet they are underrepresented in research. We conducted a bio-behavioral survey to estimate the prevalence of five curable STIs, namely: chlamydia, gonorrhea, syphilis, trichomoniasis and Mycoplasma genitalium infection, and associated risk factors among TSMSM in Nairobi, Kenya.

Methods: Between February and March 2021, we used the respondent-driven sampling (RDS) method to recruit 242 TSMSM aged ≥18 years who self-reported engaging in anal and/or oral sex with another man in the past year. Samples collected included urine, anorectal and oropharyngeal swabs for pooled Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhea and Trichomonas vaginalis testing using multiplex nucleic acid amplification tests, and venous blood for serological Treponema pallidum screening and confirmation of current infection. Participants completed a self-administered behavioral survey on REDCap® web application. Data analysis was done using RDS-Analyst (v0.72) and Stata (v15). Differences in proportions were examined using the chi-square (X²) test, and unweighted multivariate logistic regression was used to assess factors associated with STIs prevalence.

Results: Median age of participants was 21 years (interquartile range 20-22), with 96.3% aged ≤24 years. RDS-adjusted prevalence of at least one of the five STIs, chlamydia, gonorrhea, Mycoplasma genitalium infection, trichomoniasis and latent syphilis were 58.8% (confidence interval [CI] 50.4-67.3), 51.0% (42.3-59.8), 11.3% (6.1-16.5), 6.0% (2.6-9.4), 1.5% (-0.3-3.3) and 0.7% (-0.1-1.5), respectively. Factors independently associated with prevalence of at least one of the fives STIs from any anatomic site were inconsistent condom use (adjusted odds ratio [AOR] = 1.89, 95% CI: 1.03-3.47, p = 0.038) and the last sex partner being a regular partner (AOR = 2.35, 95% CI: 1.12-4.92, p = 0.023).

Conclusion: STIs prevalence among TSMSM in Nairobi is disturbingly high, necessitating urgent need for tailored testing, treatment and prevention interventions. Accurate, affordable and timely point of care tests for agents of STIs are required to optimize treatment and control. Interventions that increase condom use efficacy and offer risk reduction counseling are also requisite.